Agency/Intermediary Code - irdai

28
Part A <<Date>> <<Policyholder’s Name>> <<Policyholder’s Address>> <<Policyholder’s Contact Number>> Dear <<Policyholder’s Name>>, Sub: Your Policy no. <<>> We are glad to inform you that your proposal has been accepted and the HDFC Life New Immediate Annuity Policy (“Policy”) being this Policy, has been issued. We have made every effort to design your Policy in a simple format. We have highlighted items of importance so that you may recognise them easily. Policy document: As an evidence of the insurance contract between HDFC Life Insurance Company Limited and you, the Policy is enclosed herewith. Please preserve this document safely and also inform your Nominee(s)about the same. A copy of your proposal form and other relevant documents submitted by you are also enclosed for your information and record. Cancellation in the Free-Look Period: In case you are not agreeable to any of the provisions stated in the Policy, you have the option to return the Policy to us stating the reasons thereof, within 15 days from the date of receipt of the Policy. If you have purchased your Policy through Distance Marketing mode, this period will be 30 days. However this option will not be available in the event of purchase of this Policy from the vesting proceeds of an accumulation pension product previously purchased by you. On receipt of your letter along with the original Policy, we shall arrange to refund the Premium/Purchase Price paid by you subject to deduction of the expenses incurred by us for medical examination (if any) and stamp duty (if any). If this product is purchased as QROPS through transfer of UK tax relieved assets, the proceeds from cancellation in free look period shall only be transferred back to the Fund House from where the money was received. Contacting us: The address for correspondence is specified below. To enable us to serve you better, you are requested to quote your Policy number in all future correspondence. In case you are keen to know more about our products and services, we would request you to talk to our authorized representatives or Certified Financial Consultant (Insurance Agent) who has advised you while taking this Policy. The details of your Certified Financial Consultant including contact details are listed below. To contact us in case of any grievance, please refer to Part G. In case you are not satisfied with our response, you can also approach the Insurance Ombudsman in your region. Thanking you for choosing HDFC Life Insurance Company Limited and looking forward to serving you in the years ahead, Yours sincerely, << Designation of the Authorised Signatory >> Branch Address: <<Branch Address>> Agency/Intermediary Code: <<Agency/Intermediary Code>> Agency/Intermediary Name: <<Agency/Intermediary Name>>

Transcript of Agency/Intermediary Code - irdai

Part A

<<Date>>

<<Policyholder’s Name>>

<<Policyholder’s Address>>

<<Policyholder’s Contact Number>>

Dear <<Policyholder’s Name>>,

Sub: Your Policy no. <<>>

We are glad to inform you that your proposal has been accepted and the HDFC Life New

Immediate Annuity Policy (“Policy”) being this Policy, has been issued. We have made every

effort to design your Policy in a simple format. We have highlighted items of importance so

that you may recognise them easily.

Policy document:

As an evidence of the insurance contract between HDFC Life Insurance Company Limited

and you, the Policy is enclosed herewith. Please preserve this document safely and also

inform your Nominee(s)about the same. A copy of your proposal form and other relevant

documents submitted by you are also enclosed for your information and record.

Cancellation in the Free-Look Period:

In case you are not agreeable to any of the provisions stated in the Policy, you have the

option to return the Policy to us stating the reasons thereof, within 15 days from the date of

receipt of the Policy. If you have purchased your Policy through Distance Marketing mode,

this period will be 30 days. However this option will not be available in the event of purchase

of this Policy from the vesting proceeds of an accumulation pension product previously

purchased by you. On receipt of your letter along with the original Policy, we shall arrange to

refund the Premium/Purchase Price paid by you subject to deduction of the expenses incurred

by us for medical examination (if any) and stamp duty (if any).

If this product is purchased as QROPS through transfer of UK tax relieved assets, the

proceeds from cancellation in free look period shall only be transferred back to the Fund

House from where the money was received.

Contacting us:

The address for correspondence is specified below. To enable us to serve you better, you are

requested to quote your Policy number in all future correspondence. In case you are keen to

know more about our products and services, we would request you to talk to our authorized

representatives or Certified Financial Consultant (Insurance Agent) who has advised you

while taking this Policy. The details of your Certified Financial Consultant including contact

details are listed below.

To contact us in case of any grievance, please refer to Part G. In case you are not satisfied

with our response, you can also approach the Insurance Ombudsman in your region.

Thanking you for choosing HDFC Life Insurance Company Limited and looking forward to

serving you in the years ahead,

Yours sincerely,

<< Designation of the Authorised Signatory >>

Branch Address: <<Branch Address>>

Agency/Intermediary Code: <<Agency/Intermediary Code>>

Agency/Intermediary Name: <<Agency/Intermediary Name>>

Agency/Intermediary Telephone Number: <<Agency/Intermediary mobile &

landline number>>

Agency/Intermediary Contact Details: <<Agency/Intermediary address>>

Address for Correspondence: HDFC Life Insurance Company Limited, 11th Floor Lodha

Excelus, Apollo Mills Compound, N.M. Joshi Marg, Mahalaxmi, Mumbai-400011.

Registered Office: Lodha Excelus, 13th Floor, Apollo Mills Compound, N. M. Joshi Marg,

Mahalaxmi, Mumbai - 400 011.

Call1860-267-9999(local charges apply).DO NOT prefix any country code e.g.

+91or00.Available all days

From 9 am to 9 pm |Email – [email protected] | [email protected] (For NRI

customers only) Visit– www.hdfclife.com. CIN: L65110MH2000PLC128245.

POLICY DOCUMENT- HDFC Life New Immediate Annuity

Unique Identification Number: UIN- 101N084V19

Your Policy is a single premium non-participating and non linked annuity policy. This document is the

evidence of a contract between HDFC Life Insurance Company Limited and the Annuitant as described in

the Policy Schedule given below. This Policy is based on the Proposal made by the within named

Annuitant and submitted to the Company along with the required documents, declarations, statements, and

other information received by the Company from the Annuitant or on behalf of the Annuitant. This Policy

is effective upon receipt and realisation, by the Company, of the consideration payable as

Premium/Purchase Price under the Policy. This Policy is written under and will be governed by the

applicable laws in force in India and all Premium/Purchase Price and Benefits are expressed and payable

in Indian Rupees.

POLICY SCHEDULE

Policy number: <<>>

Client ID: <<>>

Policyholder Details

Name <<>>

Address <<>>

Annuitant Details

Annuitant Information Annuitant/Primary Annuitant Secondary Annuitant

Name <<>> <<>>

Date of Birth << dd/mm/yyyy >> << dd/mm/yyyy >>

Age on the Date of Risk

Commencement <<>> years

<<>> years

Age Admitted <<Yes/No>> <<Yes/No>>

Policy Details

Date of Commencement of Policy <<Date>>

Date of Risk Commencement << RCD >>

Date of Issue/Inception of Policy << Issue Date>>

Premium/Purchase Price Payment

Date <<dd /month>>

Plan Option <<>>

Benefits payable on Death Rs. <<>>

Benefits payable on diagnosis of

Critical Illness Rs. <<>>/<<Not Applicable>>

Guarantee Period <<>>/<<Not applicable>>

Premium/Purchase Price Paid Rs. <<>>>

Frequency of Annuity Payment << Annual/Half-yearly/ Quarterly/ Monthly >>

Annuity Amount per Frequency of

Annuity Payment Rs. <<>>

Riders

Rider Name <<>>

Rider Term <<>> years

Rider Sum Assured Rs. <<>>

The Premium/Purchase Price amount is excluding any tax and levies as applicable leviable on the

Premium/Purchase Price. Amount of tax and levies will be charged at actuals as per prevalent rate.

NOMINATION SCHEDULE

Nominee’s Name <<Nominee-1 >> <<Nominee-2 >>

Nominee’s Relationship with

the Life Assured <<>> <<>>

Date of Birth of Nominee << dd/mm/yyyy >> << dd/mm/yyyy >>

Nominee’s Age <<>>years <<>>years

Nomination Percentage <<>> % <<>> %

Nominee's Address <<>> <<>>

Appointee’s Name

<<>> (Applicable where the Nominee

is a minor)

Date of Birth of Appointee << dd/mm/yyyy >>

Appointee's Address <<>>

Signed at Mumbai on <<>>

For HDFC Life Insurance Company Limited

Authorised Signatory

Note: Kindly note that name of the Company has changed from “HDFC Standard Life Insurance Company

Limited” to “HDFC Life Insurance Company Limited”

In case you notice any mistake, you may return the Policy document to us for necessary

correction.

SPACE FOR ENDORSEMENTS

Part B

(Definitions)

Definitions in alphabetical order

1) Annuitant – means the person who is entitled to receive the annuity benefits and on

whose life the contingent events have to occur for the Benefits to be payable as stated

in the Policy Schedule.

2) Appointee – means the person named by you and registered with us in accordance

with the Nomination Schedule, who is authorised to receive the Death Benefit under

this Policy on the death of the Annuitant while the Nominee is a minor;

3) Authority/ IRDAI – means Insurance Regulatory and Development Authority of

India;

4) Company, company, Insurer, Us, us, We, we, Our, our – means or refers to HDFC

Life Insurance Company Limited.

5) Date of Risk Commencement – means the date, as stated in the Policy Schedule, on

which the insurance coverage under this Policy commences;

6) Guarantee Period – means the period, as stated in the Policy Schedule, which is

chosen by you at the time of Policy inception, for which the annuity is guaranteed to

be payable to the Annuitant or his/her Nominee upon the Annuitant’s death.

7) Nominee(s) – means the person(s) named by you and registered with us in accordance

with the Nomination Schedule, who is authorised to receive the Death Benefit under

this Policy, on the death of the Annuitant;

8) Medical Practitioner – means a person who holds a valid registration from the

medical council of any state of India and is thereby entitled to practice medicine

within its jurisdiction and is acting within the scope and jurisdiction of his license but

excluding the Practitioner who is:

a) Annuitant/Policyholder himself or an agent of the Annuitant/ Policyholder;

b) Insurance Agent, business partner(s) or employer/employee of the Annuitant/

Policyholder or;

c) A member of the Annuitant's/ Policyholders immediate family.

9) Policy Anniversary – means the annual anniversary of the Date of Risk

Commencement;

10) Policyholder, You, you, your – means or refers to the Policyholder stated in the Policy

Schedule. The Policyholder is the owner of the Policy.

11) Policy Term – means the term of the Policy as stated in the Policy Schedule;

12) Premium/Purchase Price – means an amount stated in the Policy Schedule, payable

by you to us and in the manner stated in the Policy Schedule, to secure the benefits

under this Policy, excluding taxes and levies;

13) Primary Annuitant – refers to the individual, the events in the life of whom are of

primary importance in affecting the timing or amount of payout under the contract.

14) Secondary Annuitant – refers to the second life for the purpose of joint life Annuity

option

15) Sum Assured - mean the absolute amount of benefit which is guaranteed to become

payable as per the terms and conditions specified in the Policy

16) Surrender - means complete withdrawal/ termination of the entire Policy.

17) Surrender Value - means an amount, if any, that becomes payable in case of

Surrender of the Policy in accordance with the terms and conditions of the Policy.

Part C

(Benefits)

1. Benefits:

(1) Annuity Option - Under this Policy, the amount of Benefit depends on the annuity

option and the frequency selected. The table below sets out the annuity benefits for

various options:

Annuity Option Annuity Benefits

<<Life Annuity

Annuity payments will be made in arrears for

as long as the Annuitant is alive. The annuity

payments will cease on death of the

Annuitant>>

<<Life Annuity with Return of

Premium/Purchase Price

<<Life Annuity with Return of Balance

Premium/Purchase Price

<<Life Annuity with Return of

Premium/Purchase Price in Parts

<<Life Annuity with a Guarantee Period Annuity payments will be made in arrears for

as long as the Annuitant is alive or until the

end of the Guarantee Period, whichever is

later. The annuity payments will cease on the

later of:

- death of the Annuitant; or

- completion of the Guarantee Period.

The Guarantee Period shall be as selected by

you and is set out in the Policy Schedule>>

<<Life Annuity with 5% escalation Annuity payments will be made in arrears for

as long as the Annuitant is alive. The annuity

payment will increase at a simple rate of 5%

per annum of the initial annuity payment.

For example, if the annuity amount is

Rs10,000 in the first year; the annuity will be

Rs10,500 in the second year; Rs11,000in the

third year and so on. The annuity payments

will cease on the death of the Annuitant>>

<<Life Annuity with Return of

Premium/Purchase Price on diagnosis of

Critical Illness

Annuity payments will be made in arrears.

The annuity payments will cease on the

earlier of:

- being diagnosed with a specified Critical

Illness as mentioned in the Part C Clause

1(4) before the age of 85; or

- death of the Annuitant>>

<<Joint Life Annuity with 100% annuity to

the Secondary Annuitant

100% of the annuity amount will be payable

in arrears so long as either the Primary

<<Joint Life Annuity with 100% annuity to

the Secondary Annuitant and return of

Premium/Purchase Price

Annuitant or the Secondary Annuitant is

alive. The annuity payments will cease on

later of the deaths of the two Annuitants>>

<<Joint Life Annuity with 50% annuity to the

Secondary Annuitant

100% of the annuity amount will be payable

in arrears so long as the Primary Annuitant is

alive. On the death of the Primary Annuitant,

50% of the annuity amount will be payable to

the Secondary Annuitant as long as the

Secondary Annuitant is alive. The annuity

payments will cease on later of the deaths of

the two Annuitants. If the Secondary

Annuitant predeceases the Primary

Annuitant, the annuity payments shall cease

upon the death of the Primary Annuitant>>

<<Joint Life Annuity with 50% annuity to the

Secondary Annuitant and return of

Premium/Purchase Price

(2) Death Benefit (Payable to Nominee/Legal heirs) - The Death Benefit will vary

depending on the annuity option. The table below sets out the Death Benefit for the

various options:

Annuity Option Death Benefits

<<Life Annuity None>>

<<Life Annuity with Return of

Premium/Purchase Price

100% of the Premium/Purchase Price of the

annuity will be paid to the Nominee(s)>>

<<Life Annuity with Return of

Balance Premium/Purchase Price

Excess, if any, of 100% of the Premium/Purchase

Price of the annuity less the aggregate of all

annuity installments previously paid to the

Annuitant will be paid to the Nominee(s)>>

<<Life Annuity with a Guarantee

Period

None>>

<<Life Annuity at 5% escalation None>>

<<Life Annuity with Return of

Premium/Purchase Price in Parts On

death of the Annuitant before the seventh

Policy Anniversary 100% of the

Premium/Purchase Price will be paid to the

Nominee(s)

On

death of the Annuitant after the seventh

Policy Anniversary 70% of the

Premium/Purchase Price will be paid to the

Nominee(s)>>

<<Life Annuity with Return of

Premium/Purchase Price on

diagnosis of Critical Illness

100% of the Premium/Purchase Price of the

annuity will be paid to the Nominee(s)>>

<<Joint Life Annuity with 100%

annuity to the Secondary

Annuitant

None>>

<<Joint Life Annuity with 50% None>>

annuity to the Secondary

Annuitant

<<Joint Life Annuity with 100%

annuity to the Secondary

Annuitant and return of

Premium/Purchase Price

100% of the Premium/Purchase Price of the

annuity will be paid to the Nominee(s)>>

<<Joint Life Annuity with 50%

annuity to the Secondary

Annuitant and return of

Premium/Purchase Price

100% of the Premium/Purchase Price of the

annuity will be paid to the Nominee(s)>>

The Premium/Purchase Price referred in the table above excludes tax and levies if applicable.

In case of any annuity payments being made between the date of death and the date of

intimation of such death, such annuity payments will be deducted from the death benefit

wherever applicable.

<< (3) Survival Benefit –

Life Annuity with Return of Premium/Purchase Price in Parts: Under the option Life

Annuity with Return of Premium/Purchase Price in parts, on the seventh Policy

Anniversary, 30% of the Premium/Purchase Price is payable provided the Annuitant

is alive.

(4) Benefits payable on diagnosis of Critical Illness:

Life Annuity with Return of Premium/Purchase Price on diagnosis of Critical Illness:

Annuity payments will be made in arrears. The annuity payments will cease on the

earlier of:

(a) being diagnosed with a specified Critical Illness as mentioned below before the age of

85; or

(b) death of the Annuitant.

Under the option Life Annuity with Return of Premium/Purchase Price on diagnosis

of Critical Illness, the Premium/Purchase Price excluding tax and other levies will be

paid to the Annuitant upon the diagnosis of the following Critical Illnesses:

a) Cancer of Specified Severity

A malignant tumor characterized by the uncontrolled growth and spread of malignant

cells with invasion and destruction of normal tissues. This diagnosis must be

supported by histological evidence of malignancy. The term cancer includes

leukemia, lymphoma and sarcoma.

The following are excluded –

i. All tumors which are histologically described as carcinoma in situ, benign, pre-

malignant, borderline malignant, low malignant potential, neoplasm of unknown

behavior, or non-invasive, including but not limited to: Carcinoma in situ of breasts,

Cervical dysplasia CIN-1, CIN -2 and CIN-3.

ii. Any non-melanoma skin carcinoma unless there is evidence of metastases to lymph

nodes or beyond;

iii. Malignant melanoma that has not caused invasion beyond the epidermis;

iv. All tumors of the prostate unless histologically classified as having a Gleason

score greater than 6 or having progressed to at least clinical TNM classification

T2N0M0

v. All Thyroid cancers histologically classified as T1N0M0 (TNM Classification) or

below;

vi. Chronic lymphocytic leukaemia less than RAI stage 3

vii. Non-invasive papillary cancer of the bladder histologically described as TaN0M0

or of a lesser classification,

viii. All Gastro-Intestinal Stromal Tumors histologically classified as T1N0M0 (TNM

Classification) or below and with mitotic count of less than or equal to 5/50 HPFs;

b) Open Chest CABG

The actual undergoing of heart surgery to correct blockage or narrowing in one or

more coronary artery(s), by coronary artery bypass grafting done via asternotomy

(cutting through the breast bone) or minimally invasive key hole coronary artery

bypass procedures. The diagnosis must be supported by a coronary angiography and

the realization of surgery has to be confirmed by a cardiologist.

The following are excluded:

i. Angioplasty and/or any other intra-arterial procedures

c) Myocardial Infarction

The first occurrence of heart attack or myocardial infarction, which means the death

of a portion of the heart muscle as a result of inadequate blood supply to the relevant

area. The diagnosis for Myocardial Infarction should be evidenced by all of the

following criteria:

i. A history of typical clinical symptoms consistent with the diagnosis of acute

myocardial infarction (For e.g. typical chest pain)

ii. New characteristic electrocardiogram changes

iii. Elevation of infarction specific enzymes, Troponins or other specific biochemical

markers.

The following are excluded:

i. Other acute Coronary Syndromes

ii. Any type of angina pectoris

iii. A rise in cardiac biomarkers or Troponin T or I in absence of overtischemic heart

disease OR following an intra-arterial cardiac procedure.

d) Kidney Failure Requiring Regular Dialysis

End stage renal disease presenting as chronic irreversible failure of both kidneys to

function, as a result of which either regular renal dialysis (hemodialysis or peritoneal

dialysis) is instituted or renal transplantation is carried out. Diagnosis has to be

confirmed by a specialist medical practitioner.

e) Major Organ Transplant (as recipient)

I. The actual undergoing of a transplant of:

i. One of the following human organs: heart, lung, liver, kidney, pancreas, that

resulted from irreversible end-stage failure of the relevant organ, or

ii. Human bone marrow using haematopoietic stem cells. The undergoing of a

transplant has to be confirmed by a specialist medical practitioner.

II. The following are excluded:

i. Other stem-cell transplants

ii. Where only islets of langerhans are transplanted

f) Stroke Resulting In Permanent Symptoms

Any cerebrovascular incident producing permanent neurological sequelae. This

includes infarction of brain tissue, thrombosis in an intracranial vessel, haemorrhage

and embolisation from an extracranial source. Diagnosis has to be confirmed by a

specialist medical practitioner and evidenced by typical clinical symptoms as well as

typical findings in CT Scan or MRI of the brain. Evidence of permanent neurological

deficit lasting for at least 3 months has to be produced.

The following are excluded:

i. Transient ischemic attacks (TIA)

ii. Traumatic injury of the brain

iii. Vascular disease affecting only the eye or optic nerve or vestibular functions.>>

(5) The Death Benefit is subject to the exclusions set out in Part F Clause 1 (Exclusions).

(6) Upon the payment of the Death Benefit or the Annuity Benefit, or Benefits payable on

diagnosis of Critical Illness whichever is earlier, the Policy terminates and no further

Benefits are payable.

(7) The recipients of Benefits under this Policy shall be as specified below:

(i) Death Benefit shall be payable to the registered Nominee(s), if the Policyholder and

the Annuitant are the same; or to the Policyholder if the Annuitant is other than the

Policyholder.

(ii) All other Benefits shall be payable to the Annuitant.

(iii)In case of any unique situation or doubt the Company’s decision will be final and

binding.

2. Payment and cessation of Premium/Purchase Price (1) Where the Premium/Purchase Price has been remitted otherwise than in cash, the

application of the Premium/Purchase Price received is conditional upon the

realization of the proceeds of the instrument of payment, including electronic mode.

Part D

(Policy Servicing Aspects)

1. Alterations

No alterations are permissible under the Policy.

2. Loans

No loans will be provided on your Policy.

3. Free Look Cancellation

In case the Policyholder is not agreeable to any of the terms and conditions stated in the

Policy, the Policyholder has an option to return the Policy to the Company stating the

reasons thereof, within 15 days from the date of receipt of the Policy. If the Policy has

been purchased through Distance Marketing mode, this period will be 30 days. However

this option will not be available in the event of purchase of this Policy from the vesting

proceeds of an accumulation pension product previously purchased by you. On receipt of

the Policyholder’s letter along with the original Policy document where the reasons stated

therein are found valid, the Company shall arrange to refund the Premium/Purchase Price

paid subject to deduction of the expenses incurred by us for medical examination (if any)

and stamp duty (if any).

If this product is purchased as QROPS through transfer of UK tax relieved assets, the

proceeds from cancellation in free look period shall only be transferred back to the Fund

House from where the money was received.

(4) Surrender Benefits

Surrender Benefits are available for the following three options only. The table below sets

out the Surrender Benefits as per the annuity option chosen by you:

Annuity Option Surrender Benefits

Life Annuity with Return of Purchase Price 10% of the Premium/Purchase Price

Life Annuity with Return of Purchase Price

on diagnosis of Critical Illness

10% of the Premium/Purchase Price

Life Annuity with Return of Purchase Price in

parts

10% of the Premium/Purchase Price if

surrendered within 7 years from the date of

risk commencement, 7% of the

Premium/Purchase Price if surrendered

thereafter

Surrender Benefits are not available for any other Annuity Option.

In addition, the Company may pay a Special Surrender Value depending on the prevailing

market conditions.

Currently, the Special Surrender Value (SSV) is the same as Guaranteed Surrender Value.

The SSV may be revised from time to time with prior approval of the Authority.

For the purpose of computing the Surrender Benefits, the Premium/Purchase Price

excludes tax and levies if applicable.

Part E

(Charges)

1. Additional Servicing Charges

Not applicable

Part F

(General Terms & Conditions)

1. Exclusions

There are no exclusions under this Policy.

2. Age Admitted

The Company has calculated the Premium/Purchase Price under the Policy on the basis

of the age of the Annuitant as declared in the Proposal. In case you have not provided

proof of age of the Annuitant with the Proposal, you will be required to furnish such

proof of age of the Annuitant as is acceptable to us and have the age admitted. In the

event the age so admitted (“Correct Age”) during the Policy Term is found to be

different from the age declared in the Proposal, without prejudice to our rights and

remedies including those under the Insurance Act, 1938 as amended from time to time,

we shall take one of the following actions:

i) If eligible, and if the Correct Age is found to be higher, the benefit payable under this

Policy, Rider, if any, shall be after deduction of such difference of Premium/Purchase

Price (i.e difference in Premium/Purchase Price paid based on age declared in the

Proposal and Premium/Purchase Price based on the Correct Age) along with interest

thereon. In such cases, before calculating the amount of benefit payable, the Policy

shall be subject to re-underwriting and the Sum Assured shall be subject to eligibility as

per underwriting norms and the Premium/Purchase Price to be deducted shall be

calculated proportionately on such Sum Assured payable. If the Correct Age is found

to be lower, excess Premium/ Purchase Price without any interest shall be refunded.

ii) If ineligible for the Policy basis the Correct Age, the Policy shall be void-ab-initio

and the total Premium/Purchase Price paid shall be refunded without interest after

deducting the annuity already paid to you during the Policy Term and all applicable

charges like medical, Stamp Duty, risk etc.

iii) If this product is to be purchased as QROPS (Qualifying Recognized Overseas

Pension Scheme), through transfer of UK tax relieved assets, it would be offered only

to customers who are 55 years of age or above (as on last birthday)

3. Claims Procedure

(1) Benefits payable on Death - The Benefit will be paid if and only if

(i) The death of the Annuitant has occurred (in case of Life Option),

(ii) The deaths of both Annuitants have occurred (in case of Joint Life Option),

(iii) The standard Policy provisions specified in Part F Clause 1 (Exclusions) and Part

F Clause 7 (Incorrect Information and Non Disclosure) are not attracted,

(iv) The Policy has not been surrendered or cancelled or terminated; and

(v) The documents required for processing a claim are:

Basic documentation if death is due to Natural Cause:

a. Completed claim form, (including NEFT details and bank account proof as

specified in the claim form);

b. Original Policy;

c. Original or copy Death Certificate issued by Municipal Authority/ Gram Panchayat

/ Tehsildar (attested by issuing authority);

d. Claimant’s identity and residence proof.

Basic documentation if death is due to Un-Natural Cause:

a. Completed claim form, (including NEFT details and bank account proof as

specified in the claim form);

b. Original Policy;

c. Original or copy Death Certificate issued by Municipal Authority/ Gram Panchayat

/ Tehsildar (attested by issuing authority);

d. Claimant’s identity and residence proof.

e. Original or copy of First Information Report, Police Panchnama report attested by

Police authorities; and

f. Original or copy of Postmortem report attested by Hospital authority.

Critical Illness Claim:

1. Completed claim form, (including NEFT details and bank account proof as

specified in the claim form);

2. Medical records for diagnosis and treatment of the illness

3. Doctor’s / Hospital Certificate

4. Original Policy document / Certificate of Insurance

5. Claimant’s identity and residence proof

Note:

a. In case original documents are submitted, attestation on the document by

authorities is not required.

b. Depending on the circumstances of the death, further documents may be called

for as we deem fit.

(vi) The claim is required to be intimated to us within a period of 90 days from the date

of death. However, we may condone the delay in claim intimation, if any, where

the delay is proved to be for reasons beyond the control of the claimant.

<< (2) Benefits payable on diagnosis of Critical Illness – The Benefit will be paid if and only

if

(i) The Annuitant has been diagnosed with a Critical Illness as specified in Part C

Clause 1 (4) before the age of 85;

(ii) The claim has been intimated to us within 30 days of diagnosis of the Critical

Illness; and

(iii) All relevant documents in support of the claim have been provided to the

Company i.e.

a) Claim form.

b) Original Policy Document.

c) Medical reports or special reports by registered Medical Practitioner

relevant to the Critical Illness and its treatment further validated by a

physician/doctor appointed by the Company.

d) Any other document/ information that the Insurer may decide in the

circumstances of a particular case.

<< (3) Survival Benefit - The Benefit will be paid if and only if

(i) The Annuitant(s) provide(s) proof of survival from time to time The Annuitant(s)

shall provide such proof of survival, as and when called upon to do so. The list of

acceptable proofs will be communicated from time to time. We reserve the right to

suspend the Annuity payments till the proof is provided.>>

4. Assignment

Your Policy cannot be assigned.

5. Nomination The Policyholder/Annuitant can nominate a person(s) in accordance with Section 39

of the Insurance Act, 1938 as amended from time to time. Simplified version of the

provisions of Section 39 is enclosed in Annexure I for reference.

6. Issuance of Duplicate Policy:

The Policyholder can request for a duplicate copy of the Policy at HDFC Life offices

or through Certified Financial Consultant (Insurance Agent) who advised you while

taking this Policy. While making an application for duplicate Policy the Policyholder

is required to submit a notarized original indemnity bond, an affidavit duly stamped

along with KYC documents. Additional charges may be applicable for issuance of the

duplicate Policy.

7. Incorrect Information and Non-Disclosure

Fraud, misrepresentation and forfeiture would be dealt with in accordance with

provisions of Section 45 of the Insurance Act 1938 as amended from time to time.

Simplified version of the provisions of Section 45 is enclosed in Annexure II for

reference

8. Taxes

(1) Indirect Taxes

Tax and levies shall be levied as applicable. Any taxes, statutory levy becoming

applicable in future may become payable by you by any method including by levy of

an additional monetary amount in addition to Premium/Purchase Price and or charges.

(2) Direct Taxes

Tax will be deducted at the applicable rate from the payments made under the Policy,

as per the provisions of the Income Tax Act, 1961.

9. Modification, Amendment, Re-enactment of or to the Insurance laws and

rules, regulations, guidelines, clarifications, circulars etc. thereunder

(1) This Policy is subject to-

(i) The Insurance Act, 1938 as amended from time to time,

(ii) Amendments, modifications (including re-enactment) as may be made from

time to time, and

(iii)Other such relevant Regulations, Rules, Laws, Guidelines, Circulars, Enactments

etc. as may be introduced thereunder from time to time.

(2) We reserve the right to change any of these Policy Provisions / terms and conditions

in accordance with changes in applicable Regulations or Laws, and where required, with

IRDAI’s approval.

(3) We are required to obtain prior approval from the IRDAI before making any material

changes to these provisions, except for changes of regulatory / statutory nature.

(4) We reserve the right to require submission by you of such documents and proof at all

life stages of the Policy as may be necessary to meet the requirements under Anti-

money Laundering/Know Your Customer norms and as may be laid down by IRDAI and

other regulators from time to time.

10. Jurisdiction:

This Policy shall be governed by the laws of India and the Indian Courts shall have

jurisdiction to settle any disputes arising under the Policy.

11. Notices Any notice, direction or instruction given to us, under the Policy, shall be in writing

and delivered by hand, post, facsimile or from registered electronic mail ID to:

HDFC Life Insurance Company Limited, 11th Floor, Lodha Excelus, Apollo Mills

Compound, N.M. Joshi Marg, Mahalaxmi, Mumbai - 400011.

Registered Office: Lodha Excelus, 13th Floor, Apollo Mills Compound, N.M. Joshi

Marg, Mahalaxmi, Mumbai - 400011.

E-mail: [email protected]

Or such other address as may be informed by us.

Similarly, any notice, direction or instruction to be given by us, under the Policy, shall

be in writing and delivered by hand, post, courier, facsimile or registered electronic

mail ID to the updated address in the records of the Company.

You are requested to communicate any change in address, to the Company supported

by the required address proofs to enable the Company to carry out the change of

address in its systems. The onus of intimation of change of address lies with the

Policyholder. An updated contact detail of the Policyholder will ensure that

correspondences from the Company are correctly addressed to the Policyholder at the

latest updated address.

Part G

Grievance Redressal Process

(i) The customer can contact us on the below mentioned address or at any of our

branches in case of any complaint/ grievance:

Grievance Redressal Officer

HDFC Life Insurance Company Limited

11th Floor, Lodha Excelus, Apollo Mills Compound,

N. M. Joshi Marg, Mahalaxmi, Mumbai, Maharashtra - 400011

Helpline number: 18602679999 (Local charges apply)

E-mail: [email protected]

(ii) All grievances (Service and sales) received by the Company will be responded to

within the prescribed regulatory Turn Around Time (TAT) of 15 days.

(iii)Written request or email from the registered email id is mandatory.

(iv) If required, we will investigate the complaints by taking inputs from the customer

over the telephone or through personal meetings.

(v) We will issue an acknowledgement letter to the customer within 3 working days of

the receipt of complaint.

(vi) The acknowledgement that is sent to the customer has the details of the complaint

number, the Policy number and the Grievance Redressal Officer’s name who will be

handling the complaint of the customer.

(vii) If the customer’s complaint is addressed within 3 days, the resolution communication

will also act as the acknowledgment of the complaint.

(viii) The final letter of resolution will offer redressal or rejection of the complaint along

with the appropriate reason for the same.

(ix) In case the customer is not satisfied with the decision sent to him or her, he or she

may contact our Grievance Redressal Officer within 8 weeks of the receipt of the

communication at any of the touch points mentioned in the document, failing which,

we will consider the complaint to be satisfactorily resolved.

(x) The following is the escalation matrix in case there is no response within the

prescribed timelines or if you are not satisfied with the response. The number of days

specified in the below- mentioned escalation matrix will be applicable from the date

of escalation.

Level Designation Response Time

1st Level Associate Vice President –

Customer Relations

10 working days

2nd Level (for response not

received from Level 1)

Sr. Vice President –

Customer Relations

7 working days

You are requested to follow the aforementioned matrix to receive satisfactory response

from us.

(xi) If you are not satisfied with the response or do not receive a response from us within 15

days, you may approach the Grievance Cell of IRDAI on the following contact details:

IRDAI Grievance Call Centre (IGCC) TOLL FREE NO: 155255/ 18004254732

Email ID: [email protected]

Online- You can register your complaint online at http://www.igms.irda.gov.in/

Address for communication for complaints by fax/paper:

General Manager

Consumer Affairs Department – Grievance Redressal Cell

Insurance Regulatory and Development Authority of India

Sy No. 115/1, Financial District,

Nanakramguda, Gachibowli,

Hyderabad – 500 032

2. In the event you are dissatisfied with the response provided by us, you may approach the

Insurance Ombudsman in your region. The details of the existing offices of the Insurance

Ombudsman are provided below. You are requested to refer to the IRDAI website at

“www.irdai.gov.in” for the updated details.

a. Details and addresses of Insurance Ombudsman

Office of the Ombudsman Contact Details Areas of Jurisdiction

AHMEDABAD Office of the Insurance

Ombudsman, Jeevan Prakash

Building, 6th floor, Tilak Marg,

Relief Road, Ahmedabad – 380

001.

Tel.: 079 - 25501201/02/05/06

Email: bimalokpal.ahmedabad@

ecoi.co.in

Gujarat , Dadra &

Nagar Haveli, Daman

and Diu

BHOPAL Office of the Insurance

Ombudsman, Janak Vihar

Complex, 2nd Floor, 6, Malviya

Nagar, Opp. Airtel Office, Near

Madhya Pradesh &

Chhattisgarh

New Market, Bhopal – 462 003.

Tel.: 0755 - 2769201 / 2769202

Fax: 0755 - 2769203

Email:

[email protected]

BHUBANESHWAR Office of the Insurance

Ombudsman, 62, Forest park,

Bhubneshwar – 751 009.

Tel.: 0674 - 2596461 /2596455

Fax: 0674 - 2596429

Email: bimalokpal.bhubaneswar

@ecoi.co.in

Orissa

BENGALURU Office of the Insurance

Ombudsman, Jeevan Soudha

Building, PID No. 57-27-N-19

Ground Floor, 19/19, 24th Main

Road, JP Nagar, Ist Phase,

Bengaluru – 560 078.

Tel.: 080 - 26652048 / 26652049

Email: bimalokpal.bengaluru@e

coi.co.in

Karnataka

CHANDIGARH

Office of the Insurance

Ombudsman, S.C.O. No. 101,

102 & 103, 2nd Floor, Batra

Building, Sector 17 – D,

Chandigarh – 160 017.

Tel.: 0172 - 2706196 / 2706468

Fax: 0172 - 2708274

Email: bimalokpal.chandigarh@

ecoi.co.in

Punjab , Haryana,

Himachal Pradesh,

Jammu & Kashmir ,

Chandigarh

CHENNAI Office of the Insurance

Ombudsman, Fatima Akhtar

Court, 4th Floor, 453, Anna

Salai, Teynampet, CHENNAI –

600 018.

Tel.: 044 - 24333668 / 24335284

Tamil Nadu,

Pondicherry Town and

Karaikal (which are part

of Pondicherry)

Fax: 044 - 24333664

Email: bimalokpal.chennai@ecoi

.co.in

DELHI Office of the Insurance

Ombudsman, 2/2 A, Universal

Insurance Building, Asaf Ali

Road, New Delhi – 110 002.

Tel.: 011 - 23232481 / 23213504

Email: [email protected]

o.in

Delhi

GUWAHATI Office of the Insurance

Ombudsman, Jeevan Nivesh, 5th

Floor, Nr. Panbazar over bridge,

S.S. Road, Guwahati –

781001(ASSAM).

Tel.: 0361 - 2632204 / 2602205

Email: bimalokpal.guwahati@ec

oi.co.in

Assam, Meghalaya,

Manipur, Mizoram,

Arunachal Pradesh,

Nagaland and Tripura

HYDERABAD Office of the Insurance

Ombudsman, 6-2-46, 1st floor,

"Moin Court", Lane Opp. Saleem

Function Palace, A. C. Guards,

Lakdi-Ka-Pool, Hyderabad - 500

004.

Tel.: 040 - 67504123 /

23312122 Fax: 040 - 23376599

Email: bimalokpal.hyderabad@e

coi.co.in

Andhra Pradesh,

Telangana, Yanam and

part of Territory of

Pondicherry

JAIPUR Office of the Insurance

Ombudsman, Jeevan Nidhi – II

Bldg., Gr. Floor, Bhawani Singh

Marg, Jaipur - 302 005.

Tel.: 0141 - 2740363

Email: Bimalokpal.jaipur@ecoi.

co.in

Rajasthan

ERNAKULAM Office of the Insurance Kerala, Lakshadweep,

Ombudsman, 2nd Floor, Pulinat

Bldg., Opp. Cochin Shipyard, M.

G. Road, Ernakulam - 682 015.

Tel.: 0484 - 2358759 / 2359338

Fax: 0484 - 2359336

Email: bimalokpal.ernakulam@e

coi.co.in

Mahe – a part of

Pondicherry

KOLKATA Office of the Insurance

Ombudsman, Hindustan Bldg.

Annexe, 4th Floor, 4, C.R.

Avenue, KOLKATA - 700 072.

Tel.: 033 - 22124339 /

22124340 Fax : 033 - 22124341

Email: bimalokpal.kolkata@ecoi

.co.in

West Bengal, Sikkim,

Andaman & Nicobar

Islands

LUCKNOW Office of the Insurance

Ombudsman, 6th Floor, Jeevan

Bhawan, Phase-II, Nawal Kishore

Road, Hazratganj, Lucknow -

226 001.

Tel.: 0522 - 2231330 / 2231331

Fax: 0522 - 2231310

Email: bimalokpal.lucknow@ec

oi.co.in

Districts of Uttar

Pradesh : Laitpur,

Jhansi, Mahoba,

Hamirpur, Banda,

Chitrakoot, Allahabad,

Mirzapur, Sonbhabdra,

Fatehpur, Pratapgarh,

Jaunpur,Varanasi,

Gazipur, Jalaun,

Kanpur, Lucknow,

Unnao, Sitapur,

Lakhimpur, Bahraich,

Barabanki, Raebareli,

Sravasti, Gonda,

Faizabad, Amethi,

Kaushambi, Balrampur,

Basti, Ambedkarnagar,

Sultanpur,

Maharajgang,

Santkabirnagar,

Azamgarh, Kushinagar,

Gorkhpur, Deoria, Mau,

Ghazipur, Chandauli,

Ballia, Sidharathnagar

MUMBAI Office of the Insurance

Ombudsman, 3rd Floor, Jeevan

Seva Annexe, S. V. Road,

Santacruz (W), Mumbai - 400

054.

Tel.: 022 - 26106552 / 26106960

Fax: 022 - 26106052

Email: bimalokpal.mumbai@eco

i.co.in

Goa, Mumbai

Metropolitan Region

excluding Navi Mumbai

& Thane

NOIDA Office of the Insurance

Ombudsman, Bhagwan Sahai

Palace 4th Floor, Main Road,

Naya Bans, Sector 15, Distt:

Gautam Buddh Nagar, U.P-

201301.

Tel.: 0120-2514250 / 2514252 /

2514253

Email: [email protected]

o.in

State of Uttaranchal and

the following Districts

of Uttar Pradesh: Agra,

Aligarh, Bagpat,

Bareilly, Bijnor,

Budaun, Bulandshehar,

Etah, Kanooj, Mainpuri,

Mathura, Meerut,

Moradabad,

Muzaffarnagar,

Oraiyya, Pilibhit,

Etawah, Farrukhabad,

Firozbad,

Gautambodhanagar,

Ghaziabad, Hardoi,

Shahjahanpur, Hapur,

Shamli, Rampur,

Kashganj, Sambhal,

Amroha, Hathras,

Kanshiramnagar,

Saharanpur

PATNA

Office of the Insurance

Ombudsman, 1st Floor,Kalpana

Arcade Building, Bazar Samiti

Road, Bahadurpur, Patna 800

006. Tel.: 0612-2680952

Email:

[email protected].

Bihar, Jharkhand

PUNE Office of the Insurance

Ombudsman, Jeevan Darshan

Bldg., 3rd Floor, C.T.S. No.s. 195

to 198, N.C. Kelkar Road,

Narayan Peth, Pune – 411 030.

Tel.: 020-41312555

Email: [email protected]

.in

Maharashtra, Area of

Navi Mumbai and

Thane excluding

Mumbai Metropolitan

Region

b. Power of Ombudsman-

1) The Ombudsman shall receive and consider complaints or disputes relating to—

(a) delay in settlement of claims, beyond the time specified in the regulations, framed

under the Insurance Regulatory and Development Authority of India Act, 1999;

(b) any partial or total repudiation of claims by the Company ;

(c) disputes over Premium paid or payable in terms of insurance Policy;

(d) misrepresentation of Policy terms and conditions at any time in the Policy document

or Policy contract;

(e) legal construction of insurance policies in so far as the dispute relates to claim;

(f) Policy servicing related grievances against insurers and their agents and

intermediaries;

(g) issuance of life insurance Policy, general insurance Policy including health insurance

Policy which is not in conformity with the proposal form submitted by the proposer;

(h) non-issuance of insurance Policy after receipt of Premium in life insurance; and

(i) any other matter resulting from the violation of provisions of the Insurance Act, 1938,

as amended from time to time, or the regulations, circulars, guidelines or instructions

issued by the IRDAI from time to time or the terms and conditions of the Policy

contract, in so far as they relate to issues mentioned at clauses (a) to (f).

2) The Ombudsman shall act as counsellor and mediator relating to matters specified in sub-

rule (1) provided there is written consent of the parties to the dispute.

3) The Ombudsman shall be precluded from handling any matter if he is an interested party

or having conflict of interest.

4) The Central Government or as the case may be, the IRDAI may, at any time refer any

complaint or dispute relating to insurance matters specified in sub-rule (1), to the

Insurance Ombudsman and such complaint or dispute shall be entertained by the

Insurance Ombudsman and be dealt with as if it is a complaint made under Clause (c)

provided herein below.

c. Manner in which complaint is to be made -

1) Any person who has a grievance against the Company, may himself or through his legal

heirs, nominee or assignee, make a complaint in writing to the Insurance Ombudsman

within whose territorial jurisdiction the branch or office of the Company complained

against or the residential address or place of residence of the complainant is located.

2) The complaint shall be in writing, duly signed by the complainant or through his legal

heirs, nominee or assignee and shall state clearly the name and address of the

complainant, the name of the branch or office of the Company against whom the

complaint is made, the facts giving rise to the complaint, supported by documents, the

nature and extent of the loss caused to the complainant and the relief sought from the

Insurance Ombudsman.

3) No complaint to the Insurance Ombudsman shall lie unless—

(a) the complainant makes a written representation to the Company named in the

complaint and—

i. either the Company had rejected the complaint; or

ii. the complainant had not received any reply within a period of one month after the

Company received his representation; or

iii. the complainant is not satisfied with the reply given to him by the Company;

(b) The complaint is made within one year—

i. after the order of the Company rejecting the representation is received; or

ii. after receipt of decision of the Company which is not to the satisfaction of the

complainant;

iii. after expiry of a period of one month from the date of sending the written

representation to the Company if the Company fails to furnish reply to the

complainant.

4) The Ombudsman shall be empowered to condone the delay in such cases as he may

consider necessary, after calling for objections of the Company against the proposed

condonation and after recording reasons for condoning the delay and in case the delay is

condoned, the date of condonation of delay shall be deemed to be the date of filing of the

complaint, for further proceedings under these rules.

5) No complaint before the Insurance Ombudsman shall be maintainable on the same subject

matter on which proceedings are pending before or disposed of by any court or consumer

forum or arbitrator.

Annexure I

Section 39 - Nomination by policyholder Nomination of a life insurance Policy is as below in accordance with Section 39 of the

Insurance Act, 1938 as amended by Insurance Laws (Amendment) Act, 2015 dated

23.03.2015. The extant provisions in this regard are as follows:

1) The policyholder of a life insurance on his own life may nominate a person or persons to

whom money secured by the policy shall be paid in the event of his death.

2) Where the nominee is a minor, the policyholder may appoint any person to receive the

money secured by the policy in the event of policyholder’s death during the minority of

the nominee. The manner of appointment to be laid down by the insurer.

3) Nomination can be made at any time before the maturity of the policy.

4) Nomination may be incorporated in the text of the policy itself or may be endorsed on the

policy communicated to the insurer and can be registered by the insurer in the records

relating to the policy.

5) Nomination can be cancelled or changed at any time before policy matures, by an

endorsement or a further endorsement or a will as the case may be.

6) A notice in writing of Change or Cancellation of nomination must be delivered to the

insurer for the insurer to be liable to such nominee. Otherwise, insurer will not be liable if

a bonafide payment is made to the person named in the text of the policy or in the

registered records of the insurer.

7) Fee to be paid to the insurer for registering change or cancellation of a nomination can be

specified by the Authority through Regulations.

8) On receipt of notice with fee, the insurer should grant a written acknowledgement to the

policyholder of having registered a nomination or cancellation or change thereof.

9) A transfer or assignment made in accordance with Section 38 shall automatically cancel

the nomination except in case of assignment to the insurer or other transferee or assignee

for purpose of loan or against security or its reassignment after repayment. In such case,

the nomination will not get cancelled to the extent of insurer’s or transferee’s or

assignee’s interest in the policy. The nomination will get revived on repayment of the

loan.

10) The right of any creditor to be paid out of the proceeds of any policy of life insurance

shall not be affected by the nomination.

11) In case of nomination by policyholder whose life is insured, if the nominees die before

the policyholder, the proceeds are payable to policyholder or his heirs or legal

representatives or holder of succession certificate.

12) In case nominee(s) survive the person whose life is insured, the amount secured by the

policy shall be paid to such survivor(s).

13) Where the policyholder whose life is insured nominates his (a) parents or (b) spouse or

(c) children or (d) spouse and children (e) or any of them; the nominees are beneficially

entitled to the amount payable by the insurer to the policyholder unless it is proved that

policyholder could not have conferred such beneficial title on the nominee having regard

to the nature of his title.

14) If nominee(s) die after the policyholder but before his share of the amount secured under

the policy is paid, the share of the expired nominee(s) shall be payable to the heirs or

legal representative of the nominee or holder of succession certificate of such nominee(s).

15) The provisions of sub-section 7 and 8 (13 and 14 above) shall apply to all life insurance

policies maturing for payment after the commencement of Insurance Laws (Amendment)

Act, 2015.

16) If policyholder dies after maturity but the proceeds and benefit of the policy has not been

paid to him because of his death, his nominee(s) shall be entitled to the proceeds and

benefit of the policy.

17) The provisions of Section 39 are not applicable to any life insurance policy to which

Section 6 of Married Women’s Property Act, 1874 applies or has at any time applied

except where before or after Insurance Laws (Amendment) Act, 2015, a nomination is

made in favour of spouse or children or spouse and children whether or not on the face of

the policy it is mentioned that it is made under Section 39. Where nomination is intended

to be made to spouse or children or spouse and children under Section 6 of MWP Act, it

should be specifically mentioned on the policy. In such a case only, the provisions of

Section 39 will not apply.

[Disclaimer: This is not a comprehensive list of amendments of Insurance Laws

(Amendment) Act, 2015 and only a simplified version prepared for general information.

Policy Holders are advised to refer to Insurance Laws (Amendment) Act, 2015dated

23.03.2015 for complete and accurate details.]

Annexure II

Section 45 – Policy shall not be called in question on the ground of mis-statement after

three years

Provisions regarding policy not being called into question in terms of Section 45 of the

Insurance Act, 1938, as amended by Insurance Laws (Amendment) Act, 2015 dated

23.03.2015are as follows:

1) No Policy of Life Insurance shall be called in question on any ground whatsoever after

expiry of 3 yrs from

a. the date of issuance of policy or

b. the date of commencement of risk or

c. the date of revival of policy or

d. the date of rider to the policy

whichever is later.

2) On the ground of fraud, a policy of Life Insurance may be called in question within 3

years from

a. the date of issuance of policy or

b. the date of commencement of risk or

c. the date of revival of policy or

d. the date of rider to the policy

whichever is later.

For this, the insurer should communicate in writing to the insured or legal representative

or nominee or assignees of insured, as applicable, mentioning the ground and materials on

which such decision is based.

3) Fraud means any of the following acts committed by insured or by his agent, with the

intent to deceive the insurer or to induce the insurer to issue a life insurance policy:

a. The suggestion, as a fact of that which is not true and which the insured does not

believe to be true;

b. The active concealment of a fact by the insured having knowledge or belief of the fact;

c. Any other act fitted to deceive; and

d. Any such act or omission as the law specifically declares to be fraudulent.

4) Mere silence is not fraud unless, depending on circumstances of the case, it is the duty of

the insured or his agent keeping silence to speak or silence is in itself equivalent to speak.

5) No Insurer shall repudiate a life insurance Policy on the ground of Fraud, if the Insured /

beneficiary can prove that the misstatement was true to the best of his knowledge and

there was no deliberate intention to suppress the fact or that such mis-statement of or

suppression of material fact are within the knowledge of the insurer. Onus of disproving

is upon the policyholder, if alive, or beneficiaries.

6) Life insurance Policy can be called in question within 3 years on the ground that any

statement of or suppression of a fact material to expectancy of life of the insured was

incorrectly made in the proposal or other document basis which policy was issued or

revived or rider issued. For this, the insurer should communicate in writing to the insured

or legal representative or nominee or assignees of insured, as applicable, mentioning the

ground and materials on which decision to repudiate the policy of life insurance is based.

7) In case repudiation is on ground of mis-statement and not on fraud, the premium collected

on policy till the date of repudiation shall be paid to the insured or legal representative or

nominee or assignees of insured, within a period of 90 days from the date of repudiation.

8) Fact shall not be considered material unless it has a direct bearing on the risk undertaken

by the insurer. The onus is on insurer to show that if the insurer had been aware of the

said fact, no life insurance policy would have been issued to the insured.

9) The insurer can call for proof of age at any time if he is entitled to do so and no policy

shall be deemed to be called in question merely because the terms of the policy are

adjusted on subsequent proof of age of life insured. So, this Section will not be applicable

for questioning age or adjustment based on proof of age submitted subsequently.

[Disclaimer: This is not a comprehensive list of amendments of Insurance Laws

(Amendment) Act, 2015 and only a simplified version prepared for general information.

Policy Holders are advised to refer to Insurance Laws (Amendment) Act, 2015 dated

23.03.2015 for complete and accurate details.]